What We Take For Granted
by FreelyBeYourself
Summary: ALS is a cruel, cruel disease. Twenty years after coming home from Korea, Hawkeye dies. Please read the warning posted in the beginning of the story, because this story has the potential to be very personal and could be considered triggering.
**WARNING: This has the potential to be very dark, especially if this subject strikes a personal nerve with anyone reading this. ALS is a horrible, cruel, merciless disease, one for which there is currently no cure. If I seem callous by writing this, I assure you – I have seen first-hand what ALS can do, and I mean ABSOLUTELY NO DISRESPECT here. I just wanted to express my personal experiences with this disease in friends and people I have known. That being said, because this subject is so personal for so many people, I would like to request that any reviews be courteous. I DO encourage constructive criticism, but if you have something mean to say, please say it about MY WRITING, and NOT about ALS or ALS patients or caregivers. Thank you for your understanding, and do please feel free to review – just, as I said, be courteous of others who are experiencing the horrors of ALS in some way. Also, if this subject is likely to trigger you in any way, then please stop reading here and do not continue on to the story. I do not own M*A*S*H or its characters. All information about ALS presented in this story comes from personal experience and commonly accepted research and knowledge. I am not a doctor and ALS progresses differently in everyone; do NOT take this story as an exact portrait of how the disease plays out in everyone. It is not. For any medical concerns of this or any nature, please seek real, professional medical assistance.**

It started off slowly, the symptoms so nonspecific that he merely thought he'd worked too hard or had somehow otherwise strained himself. He _almost_ didn't notice, for the longest kind of time, the strange but barely-there stiffness in his hands, his legs. When asked why he didn't always want to do things anymore – go bowling with Margaret, as had been the once-monthly custom since the war had ended; take his father out for dinner; knit (that was a big one; he'd grown rather fond of knitting during his time in Korea) – he'd always reply with the same casual remarks: "Oh, I just feel kind of tired today," or, "Something came up," or, "Sorry, Margaret, I'm just not in the mood to be beaten by a woman," (the latter comment was always followed by a snide wink, to which Margaret, if they were talking in person, would smack his arm and stomp away, and if they were talking on the phone, would tell him, "Pierce, when are you going to grow up?!" and then hang up).

He couldn't even really pinpoint a time when the symptoms had actually begun, so subtle and gradual was their onset. Joint stiffness, but not in every joint; muscle cramps, but not in every muscle. For the longest time he convinced himself he'd done too much surgery; stood too long that day at work. And it wasn't really that hard to believe that this was exactly what had happened, because old habits die hard, he'd found, and even though he was home from Korea, he still spent eight to twelve hours every day in the operating room.

By the time he realized that it was a neurological problem, he'd already spent about half a week tripping an abnormal number of times over his right foot. It wasn't that the leg wouldn't support his weight, because it would; that wasn't the problem. It wasn't even that he'd hurt himself and had a limp, or that he'd suddenly forgotten how to walk. It was just, one day after tripping for the eleventh time (by actual count), exhausted after a hard shift at the hospital, he was walking in his front door and he took a step, and his foot _dragged_ on the ground. And he stopped dead in his tracks, partly to regain his balance, but mostly because suddenly something clicked into place in his mind, and he realized that his right foot had been dragging a _lot_ over the past few days, and that the muscles had been stiff and slow to respond _for months_.

Taking a few experimental steps, he realized with rapidly budding nervousness that it wasn't the muscles at all, despite their stiffness – really, he suddenly realized, the problem was that he was telling his foot to move, and it required so much more _effort_ than he was used to. He repeated the experiment, moving his left leg, but the motion was as effortless and easy as it always had been, and suddenly he _knew_ that he hadn't merely worked too hard or stood too long or come down with the flu.

He tried, in vain, to forget about the problem, hoping that it would go away on its own with a couple days of rest. He called in sick at work; didn't show up for a week. Lied to his neighbor, saying he was going on vacation, so that he had an excuse not to go outside and collect his mail or mow his lawn. He took up residence on the couch in the living room, close to the bathroom and kitchen, hoping that the less he used his leg, the sooner it would recover. But at the end of the week, when he suddenly found himself flat on his face halfway between the stove and the couch, rice dish spilled across the floor, he was forced to admit that there was something truly wrong.

His doctor set him up with a neurologist, but told him that in the meantime there was no point in worrying. So, headed back home with the advice to take vitamin supplements – just in case – he stopped on a whim at the local gym, wondering if all he truly needed was a good workout. Maybe, he told himself, the issue wasn't that he'd worked too hard; maybe it was that he hadn't exercised enough. And when he managed to jog on the treadmill for half an hour without allowing his foot to drag even once (although, he vehemently and actively had to deny to himself how exhausted he was from the amount of work he had to put into moving his leg), he smiled, convinced that it really was just an exercise issue, and that he'd go to bed and wake up in the morning feeling like his old self.

If possible, he woke up feeling _worse_. He called in sick again, unable to get out of bed from the sheer exhaustion he was feeling. Even walking to the bathroom proved to be problematic. It wasn't like a cold; there was no stuffy nose, no sore throat. In fact, he was experiencing no real pain of any kind; just an unexplainable disconnect between his brain and his limbs, as if his brain was having to work twice as hard at telling his limbs to move, and they were just deaf to the message.

The neurologist saw him a week after the gym episode, and a look of grim determination crossed the younger man's face as he promised that he would do whatever it took to diagnose the problem.

The diagnosis wouldn't come until a year later, and by that time, it wasn't just his right foot that was affected. He was now using a walker, having progressed beyond the stages of needing a cane. He found that he couldn't lift his right arm higher than his shoulder – it was physically impossible unless he used his left arm to assist – and his left shoulder was beginning to stiffen up, too. (No, he reflected; 'stiff' wasn't entirely the right word, although there was that, too; it was more… _absent_. He knew it was his shoulder. He could reach out and touch his arm and he could feel, in his shoulder, his fingertips touching his skin. But when it came to moving it, he would tell his shoulder to raise his arm above his head, and he would, with effort, get to a point, and then the movement would stop, and no amount of trying would get the arm to function as it should. It didn't hurt, he reflected; it was just as if the connection was absent; as if it wasn't really his arm, after all, despite the fact that it was attached to his body.)

"Give it to me straight," he demanded. "Don't sugar coat anything. I'm a doctor, too. I know how it is. Just let me hear it. Don't give me time to process."

"You have ALS," the neurologist told him, and he just stared, knowing what it meant, denying that it was real, not knowing enough about it to know its full implications. The neurologist, misinterpreting his blank stare, explained. "It stands for Amyotrophic Lateral Sclerosis. It's a degenerative neurological condition affecting the motor neurons of the body… you'll get progressively worse. Eventually you may find yourself unable to speak, unable to swallow, unable to move."

"And my mind?"

The neurologist took a deep breath. "Your mind will remain perfectly intact until the end."

"So I'm doomed to live the rest of my life in a body that won't function with a mind that knows everything. Trapped, like one of my patients back at the M*A*S*H, with a severed spinal cord. I'll be able to think, and I'll be able to understand, but I won't be able to move, to talk, to communicate, or to eat."

"….Essentially, yes."

"Is there a treatment?"

"…Not at present, but research is always being done –"

"Yeah." A pause. "What will finally kill me?"

Another lengthy silence. "ALS affects every motor neuron in the body, with the exception of the bladder and eyes. You'll ultimately lose the ability to breathe, just as you've more or less lost the ability to move your right leg, and just as your left leg is getting to the point of uselessness. You'll begin to realize that breathing takes more and more effort, and eventually, just as with your leg, you simply won't be able to breathe at all, no matter how hard you try."

A deep breath, as if he was trying to suck in all of the oxygen he could _now_ , before it was too late.

"Does it always progress?"

"Benjamin… Hawkeye," the doctor said, knowing by now the man's preferred nickname. "I know what you're asking, and I don't want to give you false hope. There's nothing we can do to treat it or reverse it. Even if it were to stop progressing, you'd be stuck at the stage you're at right now. We can't give you your legs back, or your right shoulder. But… yes, there's a small chance. In some people, ALS just stops progressing, or it progresses at a much slower than expected rate. But you have to understand, the chances… they're not good."

He nodded, already having anticipated this answer.

"How long do I have?" It was amazing how he could talk about his death without any emotion, as if he were merely talking about the weather, or commenting on a World Series game many years in the past.

"Well… the average person with ALS lives about three to five years after diagnosis."

He read the neurologist's expression and saw the unwritten second clause to that statement.

"I'm not the average person."

"No… you've been progressing faster lately than you did in the beginning, and that doesn't… necessarily… speak well for your odds."

"Ah."

"I hesitate to bring this up, because I know it's one more thing that you don't want to deal with now, but Hawkeye, you might want to make… end of life arrangements. Now, I mean, while you still have the ability to express your desires."

That wouldn't be a problem. He'd moved back in with his father and written his will as soon as he'd realized that his condition was progressing. Just in case, he'd justified then; now, however, he realized that maybe part of him had known it was something like this all along.

It wasn't until a few weeks after that, that the seriousness of the situation sunk in. And then one day, while drinking his morning coffee, he swallowed too quickly and began to choke. And the choking, though not serious (this time, he reminded himself), led to the realization that he could easily die just like that in the near future, because ALS destroys one's ability to swallow, and what if that had been something solid, and he'd been home alone? And this, though not at all funny, sent him into gales of uncontrollable laughter, and he laughed and laughed so hard that the house shook, and he didn't even stop to consider that inappropriate displays of emotion such as this were another symptom of ALS, because before that thought came to his mind he was bent over double, sobbing in horror and sorrow, grieving his own premature death.

It was a month before he realized that there was a silent thought at the back of his mind, silent but growing stronger every day, and it was telling him that he should end his life now, while he still had the ability to take matters into his own hands. He thought about where he could be in another month – would he be able to use the bathroom on his own? Even since his diagnosis, he had already progressed to needing a wheelchair. What if he could no longer get himself in and out of it? He already couldn't shower by himself. It was humiliating for his _father_ to be bathing him at age fifty. He thought about letting his friends see him, paralyzed, unable to speak, losing weight from the inability to eat, choking down every breath. He didn't want that. And so he vowed, the next time he was left alone, to end his life.

He backed out at the last minute, already having swallowed the pills. He was home alone while his father went to the grocery store, and he'd jumped on the opportunity; but the thought of BJ, his best friend, not getting to say goodbye, was too much. He imagined BJ, whom he knew was trying in his own way to find a cure, standing over his grave, holding a vial of some kind of medication and sobbing as he told him, "We could have cured you, Hawk, if you'd just given us two more weeks." Before he truly knew what he was doing, he had raised his right hand – his bad hand – to his mouth and shoved two fingers down his throat. He vomited the contents of his stomach all over his lap, unable to move out of the way, but he quickly counted and knew he had gotten all of the pills. The edges of his vision blurred, a result of the emotional upheaval he was feeling, the exhaustion, and the pain from vomiting, and he realized that passing out might not be his worst idea. He didn't try to fight the feeling. His last conscious thought brought a smile to his face, because despite the Herculean effort it had taken to move his right arm that high, he had done it, and maybe that meant that he was improving, and that there was a chance he could get better even without help. He hadn't been able to lift his hand to his mouth for over a week, so the fact that he suddenly could had to be a good sign, right?

His father came home to the mess of vomit and his unconscious son, the latter with tear tracks down his cheeks. It didn't take a genius to see what had transpired. Hawkeye was never left alone again after that point, and when it became apparent that BJ was not going to find a miracle cure any time soon, Hawkeye was overcome with so much despair that he honestly didn't even know how to handle it. Soon after that, Hawkeye lost the ability to heave himself out of his wheelchair.

Another year passed, and he was now confined to bed, barely able to move his left arm, completely paralyzed in every other regard. Margaret came to visit one day, asking him how he was feeling, whether he'd read the paper, if he'd enjoyed BJ's visit the day prior. He couldn't answer any of her questions, couldn't have swallowed the piece of Danish she was eating that he was mentally begging her to share with him, couldn't even turn his head to look at her as she spoke. It was the end, and he knew it, knew it even as he struggled to force air in and out of his aching lungs; knew it even as he could feel his body dying due to lack of food. The feeding tube was doing its job, but his body was starved for more.

He wished he had killed himself when he had the chance. And why hadn't he?

False hope, he now realized. Well, no, not false hope – just hope that had been proven false now, at the end of his life. Somehow he had been certain that they would find a cure, and he would be injected with a drug, and it would save his life, and reverse the damage caused by his disease, and he'd be the same Hawkeye Pierce he'd been twenty years ago in Korea.

Someday, he was sure, they _would_ find a cure. Just not in time for him. And on so many levels, he was _not_ okay with that. It brought him no peace whatsoever when he realized that if the situation were reversed and it were _BJ_ who had been diagnosed with ALS, Hawkeye would not have let his best friend give up, either.

Hawkeye Pierce fell asleep one night, just over two years and three months after his diagnosis. Questions were running through his head: If I had sought help as soon as I'd started experiencing symptoms, would my circumstances be different now? Why didn't I say everything I needed to say while I still had the chance? What if I could have one more opportunity to tell my dad that I love him? Why does my father have to watch his son die? What if I had killed myself instead of letting my dearest friends and family see me like this? _Why me?_

He fell asleep, and sometime, during the middle of the night, his body stopped struggling to take in more air. There was no pain, no conscious awareness of the process unfolding, no fear, no more questions; the beloved surgeon just stopped breathing, and never took another breath again.

At the funeral, BJ stood there, watching as the casket was lowered into the ground. His hands were empty.


End file.
